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Interfascial Plane Blocks and Laparoscopic Abdominal Surgery: A Narrative Review

Authors Jones JH, Aldwinckle R

Received 18 July 2020

Accepted for publication 23 September 2020

Published 23 October 2020 Volume 2020:13 Pages 159—169

DOI https://doi.org/10.2147/LRA.S272694

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Stefan Wirz


James Harvey Jones, Robin Aldwinckle

Department of Anesthesiology and Pain Medicine, University of California Davis Medical Center, Sacramento, CA, USA

Correspondence: James Harvey Jones
Department of Anesthesiology and Pain Medicine, University of California Davis Medical Center, 4150 V Street, PSSB Suite 1200, Sacramento, CA 95817, USA
Tel +1 (916) 734-5031
Fax +1 (916) 734-7980
Email jamesjns137@gmail.com

Abstract: Laparoscopic abdominal surgery has become a mainstay of modern surgical practice. Postoperative analgesia is an integral component of recovery following laparoscopic abdominal surgery and may be improved by regional anesthesia or intravenous lidocaine infusion. There is inconsistent evidence supporting the use of interfascial plane blocks, such as transversus abdominis plane (TAP) blocks, for patients undergoing laparoscopic abdominal surgery as evidenced by variable patterns of local anesthetic spread and conflicting results from studies comparing TAP blocks to local anesthetic infiltration of laparoscopic port sites and multimodal analgesia. Quadratus lumborum (QL) and erector spinae plane (ESP) blocks may provide greater areas of somatic analgesia as well as visceral analgesia, which may translate to more significant clinical benefits. Aside from the locations of the surgical incisions, it is unclear what other factors should be considered when choosing one regional technique over another or deciding to infuse lidocaine intravenously. We reviewed the current literature in attempt to clarify the roles of various regional anesthesia techniques for patients undergoing laparoscopic abdominal surgery and present one possible approach to evaluating postoperative pain.

Keywords: transversus abdominis plane block, interfascial plane block, laparoscopic abdominal surgery, pain

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